Active NPI
Nicole Marie Sharp, LPTA
- Physical Therapy Assistant
- Commerce TWP, MI
National Provider Identifier
1104130020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5502002090
- Practice address
- 2600 Union Lake Rd
Suite 120
Commerce TWP, MI 48382-3588 - Phone
- (248) 366-1118
- Fax
- (248) 366-1011
- NPI assigned
- Aug 3, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502002090 | MI | Primary |
Addresses
Primary practice location
2600 Union Lake Rd
Suite 120
Commerce TWP, MI 48382-3588
Mailing address
2600 Union Lake Rd
Suite 120
Commerce TWP, MI 48382-3588
Phone (248) 366-1118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502002090 | MI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cora Health Services, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Clinic/Center
- Winter Garden, FL
- NPI 1104786805
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280793600000",
"number": "1104130020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 UNION LAKE RD",
"address_2": "SUITE 120",
"city": "COMMERCE TWP",
"state": "MI",
"postal_code": "483823588",
"telephone_number": "248-366-1118",
"fax_number": "248-366-1011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 UNION LAKE RD",
"address_2": "SUITE 120",
"city": "COMMERCE TWP",
"state": "MI",
"postal_code": "483823588",
"telephone_number": "248-366-1118",
"fax_number": "248-366-1011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARP",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-03",
"last_updated": "2010-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502002090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.